title: Pre-exposure prophylaxis for HIV infection: how antiretroviral pharmacology helps to monitor and improve adherence.
abstract: BACKGROUND
  Pre-exposure prophylaxis (PrEP) with antiretroviral drugs is a novel biomedical intervention that can prevent HIV transmission among high-risk populations. As findings from multiple PrEP studies have suggested that adherence is vital to achieve the full prevention benefits of PrEP, it is important to understand the clinical pharmacology and pharmacokinetic (PK) properties of PrEP antiretrovirals, the association of PK and PrEP efficacy, and the potential for drug concentration measurement to be used as a tool to monitor PrEP adherence.
  
  
  METHODS
  This review examines studies related to PrEP adherence with attention to the clinical pharmacology and PK of current and novel PrEP agents. Studies of animal models, PK, and clinical trials related to PrEP and adherence were reviewed.
  
  
  CONCLUSIONS
  In summary, when combined as part of a comprehensive prevention strategy that includes use of condoms and risk-reduction counseling, PrEP has tremendous promise as an adjunctive biomedical HIV prevention intervention, providing that adherence is maintained.
authors.affiliation: University of California, Antiviral Research Center, 220 Dickinson Street, Suite A, San Diego, CA 92103, USA. jblumenthal@ucsd.edu
authors.forename: Jill
authors.initials: J
authors.lastname: Blumenthal
authors.forename: Richard
authors.initials: R
authors.lastname: Haubrich
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D000818:Animals; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D004338:Drug Combinations; D016903:Drug Monitoring; D000068679:Emtricitabine; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D055118:Medication Adherence; D010757:Phosphorous Acids / Q000008:administration & dosage / Q000493:pharmacokinetics; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage* / Q000493:pharmacokinetics
chemical_list: C574165:9-(2-((bis(pivaloyloxymethoxy)phosphinoyl)methoxy)propyl)adenine; D019380:Anti-HIV Agents; D004338:Drug Combinations; D010757:Phosphorous Acids; D018894:Reverse Transcriptase Inhibitors; D003841:Deoxycytidine; D000068679:Emtricitabine; D000225:Adenine